[The association of acute polyradiculoneuritis, transitory diabetes insipidus and pregnancy. Apropos of a case and review of the literature].
This is the first report of the association of transitory diabetes insipidus with acute infective polyneuritis (landry Guillain-Barre Syndrome) occurring in pregnancy. The authors try to establish the inter-relationship between each pathological condition and pregnancy. Polyneuritis in its severe form does not seem to increase the risk of prematurity significantly. The severe forms of more generalised neurological condition as compared with the more limited condition has been noted in the literature but it is not possible to state how pregnancy effects the outcome. Plasma exchange procedures are now possible in pregnant women and the benefits of this treatment have been illustrated in severe forms of polyneuritis. There is difficulty still in selecting what criteria are sufficient to start on a therapy that is not without risk. Finally, the association between transitory diabetes insipidus and pregnancy has been reviewed in the literature and a description is given of the many physiopathological mechanisms associated with it. Diabetes insipidus is rarely found in pregnancy. All authors describe a placental factor with these troubles. The most recent theories suggest that prostaglandins and placental vasopressin are implicated. Treatment is suggested and consists of DDAVP (deamino 8-d-arginine vasopressin), which seems to be the most effective. Close collaboration between the obstetrician, the recovery services and the paediatrician is necessary to get the best results for this very severe pathological condition occurring in pregnancy.
Berteau
P
P
Service de Gynécologie-Obstétrique, Centre Hospitalier Général de Montmorency.
Morvan
J
J
Bernard
A M
AM
Verjut
J P
JP
Cléophax
J P
JP
D000328:Adult; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000188:drug therapy; D005260:Female; D006801:Humans; D010243:Paralysis / Q000150:complications; D010264:Paraplegia / Q000150:complications; D011129:Polyradiculoneuropathy / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications; D011254:Pregnancy in Diabetics / Q000188:drug therapy
D003894:Deamino Arginine Vasopressin
Association polyradiculonévrite aiguë, diabéte insipide transitoire et grossesse. A propos d'un cas et revue de la littérature.